S13054-020-03455-8.Pdf
Sakr et al. Crit Care (2021) 25:87 https://doi.org/10.1186/s13054-020-03455-8 RESEARCH Open Access Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts Yasser Sakr1, Bruno François2, Jordi Solé‑Violan3, Katarzyna Kotfs4, Ulrich Jaschinski5, Angel Estella6, Marc Leone7, Stephan M. Jakob8, Xavier Wittebole9, Luis E. Fontes10, Miguel de Melo Gurgel1, Thais Midega11, Jean‑Louis Vincent12* , V. Marco Ranieri13 and the SOAP and ICON Investigators Abstract Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiol‑ ogy and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investi‑ gated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n 3147), and May 8–18, 2012 (ICON audit, n 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS= was defned retrospectively using the Berlin= defnitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6)= days in ICON.
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